This paper analyzed the estimated prevalence, and modeled possible determinants of, moderate acute malnutrition and severe acute malnutrition (SAM) for Indigenous Batwa and non-Indigenous Bakiga of Kanungu District in Southwestern Uganda. The authors characterize possible mechanisms driving differences in malnutrition. Retrospective cross-sectional surveys were administered to 10 Batwa communities and 10 matched Bakiga Local Councils during April of 2014. Individuals were classified as moderate acute malnutrition and SAM based on middle upper-arm circumference for their age-sex strata. Malnutrition is high among Batwa children and adults, with nearly half of Batwa adults and nearly a quarter of Batwa children meeting moderate acute malnutrition criteria. SAM prevalence is lower than moderate acute malnutrition prevalence, with SAM highest among adult Batwa males. SAM prevalence among children was higher for Batwa males compared to Bakiga males. Models that incorporated community ethnicity explained the greatest variance in middle upper-arm circumference values. This research demonstrates inequality in malnutrition between the Indigenous Batwa and non-Indigenous Bakiga of Kanungu District, Uganda, with model results suggesting further investigation into the role of ethnicity as an upstream social determinant of health.
Equity in Health
The methodology of priority setting in health care has reached an advanced stage of development, but it is difficult to integrate public health and social interventions into the traditional cost effectiveness approach. Priority setting tends to be drawn towards cost-benefit rather than cost effectiveness analysis, a much more demanding methodology. Furthermore, analysis of equity requires modelling differential responses by subgroup, again increasing complexity. There has been some work by economists on how society values identical health gains for different population groups. In principle, this research can be used to adjust cost-effectiveness ratios for equity concerns. However, studies so far have been relatively small scale and tentative in their conclusions. Given the methodological challenges, policy makers (including the UK government) have developed a more pragmatic approach towards priority setting, in the form of descriptive health impact assessments. These are likely to be especially helpful when examining cross-departmental initiatives.
The purpose of this paper is to explore the socio-cultural context of cardiovascular disease (CVD) risk prevention and treatment in sub-Saharan Africa (SSA). It discusses risk factors specific to the SSA context, including poverty, urbanisation, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. It found that the epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanisation, poverty and lack of government programmes also drive this epidemic and hampers proper prevention, surveillance and treatment efforts.
Governments are incentivized to develop and implement health action programs focused on equity to ensure progress with effective strategies or interventions. This study identified strategies that facilitate the reduction of health inequalities. A systematic search strategy identified 4095 articles, of which 97 were included in the synthesis. Most of the studies included focused on the general population, vulnerable populations and minority populations. The subjects of general health and healthy lifestyles were the most commonly addressed. According to the classification of the type of intervention, the domain covered most was the delivery arrangements, followed by the domain of implementation strategies. The most frequent group of outcomes was the reported outcome in (clinical) patients, followed by social outcomes. The authors note that the strategies that facilitate the reduction of health inequalities must be intersectoral and multidisciplinary in nature, including all sectors with the health system.
The World Summit is expected to bring together more than 170 Heads of State and Government: the largest gathering of world leaders in history. It is a once-in-a-generation opportunity to take bold decisions in the areas of development, security, human rights and reform of the United Nations. Proposals in the area of development call for breakthroughs in debt relief and trade liberalization, and increases in aid to revitalize infrastructure and improve health and education services, in order to achieve the Millennium Development Goals (MDGs), including cutting extreme poverty in half by 2015 (www.un.org/millenniumgoals ).
This report presents the preliminary findings of a study undertaken in six pilot countries – Uganda, Rwanda, Kenya, Tanzania, Burundi and DR Congo. The objectives of the study were to provide a detailed assessment of food security-related initiatives, plans and strategies and also to describe the status of food security in the six countries. Based on the experiences and lessons learnt thereof, the study proposed ways of enhancing synergies and coherence between the identified food security initiatives of the regional economic communities (RECs), inter-governmental organisations (IGOs) and individual member states within Eastern Africa, to strengthen regional and country-specific partnerships in the development of a regional food security programme for Eastern Africa.
This year’s World Health Assembly began and closed rather dramatically. This article describes the highlights of the meeting and the decisions made on various health issues which include the selection of the next WHO Director General, a global strategy on IPRs and health research, the medical brain drain and the prevention of STIs.
The Transkei's infant mortality rate speaks volumes about the poverty of the people and their services.
Angola's civil war, which has isolated thousands of communities from the outside world for long periods over the past three decades, might also have prevented the rapid spread of HIV/AIDS across the country.
The Angolan government plans to launch an HIV/AIDS testing and counselling project to analyse the prevalence of the disease in the country, official news agency Angop has reported.